Specific Mutations Associated with Improved Survival with Iressa® in NSCLC
According to a recent article published in the Journal of Clinical Oncology, specific mutations within the epidermal growth factor receptor (EGFR) pathway are associated with improved survival in patients with non-small cell lung cancer (NSCLC) treated with Iressa®.
Lung cancer is the leading cause of cancer deaths in the United States. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and refers to the type of cell within the lung that the cancer originated. Patients with advanced or recurrent NSCLC are left with few effective treatment options, with therapy mainly utilized to improve quality of life and/or increase the duration of survival.
Iressa® (gefinitib) is an agent that has been approved for the treatment of recurrent NSCLC. Iressa® targets the EGFR pathway in cells, which is involved in cellular replication and spread. However, only approximately 10% of patients with NSCLC respond to therapy with Iressa®. Furthermore, it is not necessary for cancer cells to overexpress EGFR in order to respond to therapy. Researchers have been evaluating specific biological characteristics of cancer to help determine the processes through which Iressa® produces its anti-cancer responses. No clinical trials to date have demonstrated a survival advantage with the use of Iressa®, only anti-cancer responses. Because of this, committees associated with the Food and Drug Administration (FDA) have planned meetings to discuss the future of Iressa®.
Researchers from Japan recently analyzed samples of lung cancer from patients treated with Iressa®. This study included samples from 59 patients with recurrent NSCLC who were treated with Iressa®. The researchers analyzed the samples for specific mutations (genetic alterations) that may be associated with different responses or survival in these patients. Overall, the researchers discovered that specific mutations were associated with a significant increase in anti-cancer responses and survival in these patients. At one and a half years following treatment, approximately 75% of patients with the identified mutations were still alive, compared to only approximately 35% of patients who did not have the mutations.
The researchers concluded that the identified mutations indicate improved anti-cancer responses and significantly improved survival in patients with recurrent NSCLC treated with Iressa®. The researchers suggest that future clinical trials be planned to evaluate the effectiveness of Iressa® with other treatment strategies in patients with the identified mutations.
Reference: Mitsudomi T, Kosaka T, Endoh H, et al. Mutations of the Epidermal Growth Factor Receptor Gene Predict Prolonged Survival After Gefitinib Treatment in Patients With Non–Small-Cell Lung Cancer With Postoperative Recurrence. Journal of Clinical Oncology. 2005; 23: 2513-2520.
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